Surgical device having non-circular cross-section

ABSTRACT

A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity. The apparatus may include a seal anchor member comprising a compressible material. The seal anchor member may be adapted to transition between a first condition for insertion of at least a portion of the seal anchor member within a tissue tract and a second condition to facilitate a securing of the seal anchor member within a tissue tract and in substantial scaled relation with tissue surfaces defining a tissue tract. The seal anchor member may have proximal and distal ends and may define at least one port extending between the proximal and distal ends, the at least one port being adapted for the reception of an object whereby compressible material defining the at least one port is adapted to deform to establish a substantial scaled relation with the object. The seal anchor member may have a non-circular cross-section.

CROSS REFERENCE TO RELATED APPLICATION

The present application claims the benefit of and priority to U.S.Provisional Application Ser. No. 61/231,806 filed on Aug. 6, 2009, theentire contents of which are incorporated herein by reference.

BACKGROUND

1. Technical Field

The present disclosure relates to a seal for use in a surgicalprocedure. More particularly, the present disclosure relates to a sealanchor member adapted for insertion into an incision in tissue, and, forthe scaled reception of one or more surgical objects such that asubstantially fluid-tight seal is formed with both the tissue and thesurgical object, or objects.

2. Background of the Related Art

Today, many surgical procedures are performed through small incisions inthe skin, as compared to the larger incisions typically required intraditional procedures, in an effort to reduce both trauma to thepatient and recovery time. Generally, such procedures are referred to as“endoscopic”, unless performed on the patient's abdomen, in which casethe procedure is referred to as “laparoscopic”. Throughout the presentdisclosure, the term “minimally invasive” should be understood toencompass, e.g., endoscopic, laparoscopic, arthroscopic, thoracicprocedures.

During a typical minimally invasive procedure, surgical objects, such assurgical access devices, e.g., trocar and cannula assemblies, orendoscopes, are inserted into the patient's body through the incision intissue. In general, prior to the introduction of the surgical objectinto the patient's body, insufflation gases are used to enlarge the areasurrounding the target surgical site to create a larger, more accessiblework area. Accordingly, the maintenance of a substantially fluid-tightseal is desirable so as to inhibit the escape of the insufflation gasesand the deflation or collapse of the enlarged surgical site.

To this end, various valves and seals are used during the course ofminimally invasive procedures and are widely known in the art. However,a continuing need exists for a seal anchor member that can be inserteddirectly into an incision in tissue in a narrow area, such as a cavitybetween two ribs, and that can accommodate a variety of surgical objectswhile maintaining the integrity of an insufflated workspace.

SUMMARY

According to an embodiment of the present invention, there is provided asurgical apparatus for positioning within a tissue tract accessing anunderlying body cavity includes a seal anchor member comprising acompressible material and being adapted to transition between a firstexpanded condition and a second compressed condition. The first expandedcondition facilitates a securing of the seal anchor member within thetissue tract and in substantial scaled relation with tissue surfacesdefining the tissue tract, and the second compressed conditionfacilitates an at least partial insertion of the seal anchor memberwithin the tissue tract. The seal anchor member may be formed of a foammaterial, which may be at least partially constituted of a materialselected from the group consisting of polyisoprene, urethane, andsilicone. Alternatively, the seal anchor member may be formed of a gelmaterial.

The seal anchor member includes proximal and distal ends that defineelongated, e.g., oval or oblong, perimeters to facilitate thepositioning of the seal anchor member within a tissue tract accessing anunderlying body cavity. At least one of the proximal and distal ends ofthe seal anchor member may exhibit an arcuate configuration, which maybe either concave or convex. The seal anchor member may be rolled,twisted, or otherwise deformed to fit nonlinearly into the tissue tract.The seal anchor member may also be cut to better suit a surgicalprocedure.

At least one port extends between the proximal and distal ends and isadapted for the reception of an object whereby compressible materialdefining the at least one port is adapted to deform to establish asubstantial sealed relation with the object. The at least one port maycontain at least an undercut to protect against fluid leaks. The sealanchor member may include a plurality of ports that may be configuredlinearly with respect to the major diameter of the perimeter of at leastone of the distal and proximal ends. Each port may be spaced equallyfrom its neighboring ports.

According to an embodiment of the present invention, there is provided asurgical apparatus for positioning within a tissue tract accessing anunderlying body cavity, which comprises: a seal anchor member comprisinga compressible material. The seal anchor member may be adapted totransition between a first condition for insertion of at least a portionof the seal anchor member within a tissue tract and a second conditionto facilitate a securing of the seal anchor member within a tissue tractand in substantial scaled relation with tissue surfaces defining atissue tract. The seal anchor member may have proximal and distal endsand define at least one port extending between the proximal and distalends, the at least one port being adapted for the reception of an objectwhereby compressible material defining the at least one port is adaptedto deform to establish a substantial sealed relation with the object.The seal anchor member may have a non-circular cross-section.

The seal anchor member may be formed of a foam material. The foammaterial may be at least partially constituted of a material selectedfrom the group consisting of polyisoprene, urethane, and silicone. Theseal anchor member may also be formed of a gel material. The at leastone port may include at least one undercut to reduce the likelihood ofleaks therethrough. Also, the surgical apparatus may include indiciathat indicates to a user a location at which the apparatus may be cut.The seal anchor member may include a plurality of ports, and theplurality of ports may be configured linearly with respect to eachother. Each port of the plurality of ports may be spaced equally fromits neighboring ports. In use, the seal anchor member may have aninitial expanded condition, and may be adapted to be compressed by anexternal compressing force from the initial expanded condition to thefirst condition to facilitate insertion of at least a portion of theseal anchor member within a tissue tract, the anchor seal member beingfurther adapted upon removal of the compressing force to expand towardsits initial expanded condition and to its second condition to facilitatea securing of the seal anchor member within a tissue tract and insubstantial sealed relation with tissue surfaces defining a tissuetract.

According to another embodiment of the present invention, there isprovided a surgical apparatus for positioning within a tissue tractaccessing an underlying body cavity, which comprises: a seal anchormember comprising a compressible material; the seal anchor member beingadapted to transition between a first condition for insertion of atleast a portion of the seal anchor member within a tissue tract and asecond condition to facilitate a securing of the seal anchor memberwithin a tissue tract and in substantial sealed relation with tissuesurfaces defining a tissue tract, the seal anchor member having proximaland distal ends and defining a plurality of ports extending between theproximal and distal ends, at least one of the plurality of ports beingadapted for the reception of an object whereby compressible materialdefining the at least one port is adapted to deform to establish asubstantial sealed relation with the object, wherein the plurality ofports are arranged linearly relative to each other.

The seal anchor member may be formed of a foam material. The foammaterial may be at least partially constituted of a material selectedfrom the group consisting of polyisoprene, urethane, and silicone. Theseal anchor member may also be formed of a gel material. The port mayinclude at least one undercut to reduce the likelihood of leakstherethrough. The surgical apparatus may include indicia that indicatesto a user a location at which the apparatus may be cut. The seal anchormember may have a non-circular cross-section. Each port may be spacedequally from its adjacent ports. In use, the seal anchor member may havean initial expanded condition, and may be adapted to be compressed by anexternal compressing force from the initial expanded condition to thefirst condition to facilitate insertion of at least a portion of theseal anchor member within a tissue tract, the anchor seal member beingfurther adapted upon removal of the compressing force to expand towardsits initial expanded condition and to its second condition to facilitatea securing of the seal anchor member within a tissue tract and insubstantial sealed relation with tissue surfaces defining a tissuetract.

According to still another embodiment of the present invention, there isprovided a surgical apparatus for positioning within a tissue tractaccessing an underlying body cavity, which comprises: a seal anchormember comprising a compressible material; the seal anchor member beingadapted to transition between a first condition for insertion of atleast a portion of the seal anchor member within a tissue tract and asecond condition to facilitate a securing of the seal anchor memberwithin a tissue tract and in substantial sealed relation with tissuesurfaces defining a tissue tract, the seal anchor member having proximaland distal ends and defining at least one port extending between theproximal and distal ends, the at least one port being adapted for thereception of an object whereby compressible material defining the atleast one port is adapted to deform to establish a substantial sealedrelation with the object, and wherein the at least one port includes anundercut to reduce the likelihood of leaks therethrough.

According to still another embodiment of the present invention, there isprovided a seal anchor member formed from a foam material and beingelongated in cross-section, the member being configured and dimensionedto be compressed for insertion into an incision and, once inserted, toexpand so as to be secured within and seal against the incision, theseal anchor member defining at least one port extending generallylongitudinally and being adapted for sealed reception of a surgicalobject. When the seal anchor member is positioned within an incision,the seal anchor member may exert a biasing force against the incision.Advantageously, when positioned within an elongated incision, thebiasing force exerted by the seal anchor member against the incision issubstantially equal around a perimeter of the seal anchor member. Thefoam material may be at least partially constituted of a materialselected from the group consisting of polyisoprene, urethane, andsilicone. The seal anchor member may include a plurality of ports.

According to still another embodiment of the present invention, there isprovided a seal anchor member formed from a foam material, the memberbeing configured and dimensioned to be compressed for insertion into anelongated incision and, once inserted, to expand so as to exert abiasing force against the elongated incision, the seal anchor memberhaving a shape in cross-section such that the biasing force exerted bythe seal anchor member against the elongated incision is substantiallyequal around a perimeter of the seal anchor member. The seal anchormember may define at least one port extending generally longitudinallyand being adapted for sealed reception of a surgical object. The foammaterial may be at least partially constituted of a material selectedfrom the group consisting of polyisoprene, urethane, and silicone. Theseal anchor member may include a plurality of ports. The seal anchormember may define a major diameter in a first direction and a minordiameter in a second direction that is perpendicular to the firstdirection, the major diameter being greater than the minor diameter. Theseal anchor member may include an intermediate portion and an endportion, at least one of a major diameter and a minor diameter of theend portion being greater than a major diameter or a minor diameter ofthe intermediate portion so as to aid in retaining the seal anchormember within an incision.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present disclosure are described hereinbelowwith references to the drawings, wherein:

FIG. 1 is a top, perspective view of a surgical apparatus in accordancewith the principles of the present disclosure shown in an expandedcondition illustrating a seal anchor member positioned relative to thetissue;

FIG. 2 is a side, schematic view of the seal anchor member of FIG. 1;

FIG. 3 is a cross-sectional view of the seal anchor member of FIG. 1taken along section line 3-3 of FIG. 1 illustrating a plurality of portsdefining undercuts;

FIG. 4 is a side, schematic view of a port of the seal anchor member ofFIG. 2 with a surgical object inserted therethrough;

FIG. 5 is a perspective, schematic view of the seal anchor member ofFIG. 1 shown in a compressed condition prior to the insertion thereofinto an incision in tissue;

FIG. 6 is a perspective, schematic view of the seal anchor member ofFIG. 1 shown in the expanded condition and subsequent to its insertioninto the incision;

FIG. 7 is a lop, plan view of the seal anchor member of FIG. 1 in arolled state; and

FIGS. 8A-8D are perspective views of a surgical apparatus in accordancewith another embodiment of the present disclosure illustrating a sealanchor member cut to varying lengths.

DETAILED DESCRIPTION OF THE EMBODIMENTS

In the drawings and in the description which follows, in which likereferences numerals identify similar or identical elements, the term“proximal” will refer to die end of the apparatus which is closest tothe clinician during use, while the term “distal” will refer to the endwhich is furthest from the clinician, as is traditional and known in theart.

With reference to FIGS. 1-4, a surgical apparatus 10 for use in asurgical procedure, e.g., a minimally invasive procedure is illustrated.Surgical apparatus 10 includes seal anchor member 100 having proximalend 102 and distal end 104. Seal anchor member 100 includes one or moreports 108, i.e., lumen, that extend through seal anchor member 100between proximal end 102 and distal end 104.

Seal anchor member 100 is formed from a suitable foam material havingsufficient compliance to form a seal about one or more surgical objects,shown generally as surgical object “I” (FIG. 4), and also establish ascaling relation with tissue “T”. The foam is sufficiently compliant toaccommodate motion of the surgical object “I”. In one embodiment, thefoam includes a polyisoprene material. An example of an anchor memberformed of, e.g., foam, is disclosed in applicant's co-pending U.S.patent application Ser. No. 12/244,024, filed Oct. 2, 2008, the entirecontents of which are hereby incorporated by reference herein.

Proximal end 102 of seal anchor member 100 defines a first majordiameter D₁ and distal end 104 defines a second major diameter D₂. In anembodiment of seal anchor member 100, the respective first and secondmajor diameters D₁, D₂ of the proximal and distal ends 102, 104 aresubstantially equivalent, as seen in FIG. 2, although an embodiment ofseal anchor member 100 in which diameters D₁, D₂ are different is alsowithin the scope of the present disclosure. Also, proximal end 102 ofseal anchor member 100 defines a first minor diameter D₃ and distal end104 defines a second minor diameter D₄. In an embodiment of seal anchormember 100, the respective first and second minor diameters D₃, D₄ ofthe proximal and distal ends 102, 104 are substantially equivalent, asseen in FIG. 2, although an embodiment of seal anchor member 100 inwhich diameters D₃, D₄ are different is also within the scope of thepresent disclosure. Advantageously, first and second major diameters D₁,D₂ of the proximal and distal ends 102, 104 are greater than first andsecond minor diameters D₃, D₄ of the proximal and distal ends 102, 104,such that the seal anchor member 100 has, in cross-section, anon-circular, e.g., oblong, oval, race-track, etc., shape.

As depicted in FIG. 1, positioning members 114 of proximal and distalends 102, 104 may define arcuate surfaces to assist in the insertion ofseal anchor member 100 within a tissue tract 12 defined by tissuesurfaces 14 and formed in tissue “T”, e.g., an incision, as discussed infurther detail below. Alternatively, proximal and distal ends 102, 104may define substantially planar surfaces or substantially arcuatesurfaces. Embodiments are contemplated herein in which either or both ofproximal and distal ends 102, 104 define surfaces that are either orboth arcuate or planar. The arcuate surfaces may be either or bothconcave or convex.

Intermediate portion 106 extends between proximal and distal ends 102,104 to define a dimension, or length, “L” therealong. Intermediateportion 106 further defines an intermediate major diameter “R”substantially parallel to major diameters D₁, D₂. The dimension “R” ofintermediate portion 106 may remain substantially uniform along thedimension “L” thereof. Alternatively, the dimension “R” of intermediateportion 106 may vary along the dimension, or length, “L” thereof,thereby defining a cross-sectional dimension that varies along itslength “L”, which facilitates the anchoring of seal anchor member 100within tissue “T”. In addition, intermediate portion 106 may furtherdefine an intermediate minor diameter “R₂” substantially perpendicularto major diameter R. Advantageously, the intermediate minor diameter“R₂” may be smaller than the major diameter R, such that the seal anchormember 100 has, in cross-section, a non-circular, e.g., oblong, oval,race-track, etc., shape.

The dimension “R” of intermediate portion 106 may be appreciably lessthan the respective major axes D₁, D₂ of proximal and distal ends 102,104 to assist in anchoring seal anchor member 100 within tissue “T” asdiscussed in further detail below. However, in an alternate embodiment,the dimension “R” of intermediate portion 106 may be substantiallyequivalent to the respective major axes D₁, D₂ of proximal and distalends 102, 104. In cross section, intermediate portion 106 may exhibitany suitable elongated configuration, e.g., substantially oval oroblong, for insertion into a narrow incision.

Each port 108 is configured to removably receive the surgical object“I”. Prior to the insertion of surgical object “I”, port 108 is in afirst state in which port 108 defines a first or initial dimensionD_(P1). Port 108 may define an opening within seal anchor member 100having an initial open state. Alternatively, D_(P1) may be about 0 mmsuch that the escape of insufflation gas (not shown) through port 108 ofseal anchor member 100 in the absence of surgical object “I” issubstantially inhibited. For example, port 108 may be a slit extendingthe length “L” of seal anchor member 100 through proximal and distalends 102, 104.

Upon the introduction of surgical object “I”, port 108 transitions to asecond state in which port 108 defines a second, larger dimension D_(P2)that substantially approximates the diameter D₁ of surgical object “I”such that a substantially fluid-tight seal is formed therewith, therebysubstantially inhibiting the escape of insufflation gas (not shown)through port 108 of seal anchor member 100 in the presence of surgicalobject “I”. D₁, and thus D_(P2), will generally lie within the range ofabout 5 mm to about 12 mm, as these dimensions are typical of thesurgical objects used during the course of minimally invasiveprocedures. However, a seal anchor member 100 including a port 108 thatis capable of exhibiting substantially larger, or smaller, dimensions inthe second state thereof is not beyond the scope of the presentdisclosure. Seal anchor member 100 may include a plurality of generallytubular port segments (not shown) defining ports 108. In addition, sealanchor 100 may be devoid of ports 108. With this arrangement, ports 108are created within seal anchor member 100 during the insertion of thesurgical object “I”. In accordance with this embodiment, seal anchormember 100 is formed of a flowable or sufficiently compliant materialsuch as a foam material, e.g., an open-cell polyurethane foam, or a gel.

Ports 108 may include ports 108 a, which contain at least one undercut118 that collects insufflation gas that leaks through the substantiallyfluid-light seal between a surgical instrument “I” and a port 108 a.Each undercut 118 defines a diameter D_(P3) greater than D_(P2) and alength along a port 108 a less than “L”. Insufflation gas that leaksthrough a substantially fluid-tight seal between an instrument “I” and aport 108 a may collect in an undercut 118 to inhibit further leakage ofthe gas through the substantially fluid-tight seal. Furthermore, theundercuts 118 provide edges (where the respective diameters D_(P1) ofthe lumen 108 transition to the diameters D_(P3) of the undercut 118)that engage the outer surfaces of the instruments “I” insertedtherethrough to further reduce leakage. Ports 108 may also include ports108 b, which do not contain undercuts 118, or any combination of ports108 a and ports 108 b.

Generally, ports 108 are arranged linearly with respect to majordiameter D₁. Ports 108 may alternatively be arranged linearly withrespect to major diameter D₂ or dimension “R”. However, embodiments inwhich ports 108 are arranged nonlinearly, e.g., an oval or zigzagpattern, are also within the scope of this disclosure. Each port 108 maybe spaced equally from its neighboring ports. However, embodiments inwhich ports 108 are spaced unequally are also within the scope of thisdisclosure.

Referring now to FIGS. 1 and 5, seal anchor member 100 is adapted totransition from an expanded condition (FIG. 1) to a compressed condition(FIG. 5) so as to facilitate the insertion and securement thereof withintissue tract 12 in tissue “T”. In the expanded condition, seal anchormember 100 is at rest and the respective major axes D₁, D₂ of theproximal and distal ends 102, 104 of seal anchor member 100, as well asthe dimension “R” of the intermediate portion 106 are such that the sealanchor member 100 cannot be inserted within tissue tract 12. However, asseen in FIG. 5, in the compressed condition, proximal and distal ends102, 104 of seal anchor member 100 as well as intermediate portion 106are dimensioned for insertion into tissue tract 12.

Seal anchor member 100 is formed of a biocompatible compressiblematerial that facilitates the resilient, reciprocal transitioning ofseal anchor member 100 between the expanded and compressed conditionsthereof. In one embodiment, the compressible material is a “memory”foam. An external force “F” is applied to seal anchor member 100 tocause the seal anchor member 100 to assume the compressed condition.External force “F” is directed inwardly and when seal anchor member 100is subjected thereto, e.g., when seal anchor member 100 is squeezed,seal anchor member 100 undergoes an appreciable measure of deformation,thereby transitioning into the compressed condition.

As depicted in FIG. 5, as seal anchor member 100 is compressed under theinfluence of external force “F” an internal biasing force “F_(B1)” iscreated within seal anchor member 100 that is directed outwardly,opposing force “F”. Internal biasing force “F_(B1)” endeavors to expandseal anchor member 100 and thereby return seal anchor member 100 towardsthe expanded condition thereof. Accordingly, as long as seal anchormember 100 is subject to external force “F” greater than biasing force“F_(B1)”, seal anchor member 100 is compressed, and, once compressed, aslong as external force “F” at least equals biasing force “F_(B1)”, sealanchor member 100 remains in the compressed condition. Upon the removalof external force “F” biasing force “F_(B1)” acts to return seal anchormember 100 towards the expanded condition.

The compressible material comprising seal anchor member 100 alsofacilitates the resilient transitioning of port 108 between its firststate (FIGS. 1-3) and its second state (FIG. 5). As previouslydiscussed, prior to the insertion of surgical object “I”, port 108 is inits first state in which port 108 defines a first or initial dimensionD_(P1). Port 108 may incorporate a slit extending the length “L” of sealanchor member 100. In this first state, port 108 is at rest and is notsubject to any external forces. However, upon the introduction ofsurgical object “I” through port 108 as depicted in FIG. 4, the surgicalobject “I” exerts a force “F₁” upon port 108 that is directed radiallyoutward. Force “F₁” acts to enlarge the dimensions of port 108 andthereby transition port 108 into the second state thereof in which port108 defines a second, larger dimension D_(P2) that substantiallyapproximates the diameter D₁ of surgical object “I”. Consequently, aninternal biasing force “F_(B2)” is created that is directed radiallyinward, in opposition to force “F₁”. Internal biasing force “F_(B2)”endeavors to return port 108 to reduce the internal dimension of port108 and thereby return port 108 to the first state thereof. Internalbiasing force “F_(B2)” is exerted upon surgical object “I” and acts tocreate a substantially fluid-tight seal therewith. The significance offorces “F_(B1)” and “F_(B2)” will be discussed in further detail below.

It should be noted that, according to various embodiments of the presentinvention, a particular advantage of the seal anchor member 100 may bethat, when the seal anchor member 100 is positioned within an elongatedincision, the biasing force exerted by the seal anchor member 100against the incision is substantially equal around a perimeter of theseal anchor member 100. For example, many incisions made during surgeryare formed by a surgeon cutting through skin and/or tissue with ascalpel, which generally forms an incision shaped like a slit. Thisslit-shaped incision is elongated, e.g., relatively narrow in onedirection and relatively long in the perpendicular direction—thus, aseal anchor member that has a circular cross-section is required to bemore compressed in one direction than in another direction in order tobe inserted within an elongated incision, making such a seal anchormember more difficult to insert within the incision. Additionally, oncea seal anchor member with a circular cross-section is positioned withinthe incision, such a seal anchor member may generate different biasingforces against the incision at various positions around its perimeter.This may cause the sealing effect between such a seal anchor member tobe different at various positions around the seal anchor member'sperimeter and may result in an increased likelihood of leakage, e.g., atthe furthermost ends of the elongated incision where the seal anchormember has experienced the least amount of compression and thus isexerting the least amount of biasing force against the incision. Incontrast, an elongated seal anchor member, e.g., that has a majordiameter that is greater than a minor diameter, may advantageously becompressed a substantially equal amount in all directions in order to beinserted within an elongated incision, thus easing its insertion.Furthermore, once an elongated seal anchor member is positioned withinthe incision, the elongated seal anchor member may generatesubstantially equal biasing forces against the incision around itsentire perimeter. This may result in a more constant sealing effectbetween the seal anchor member and the incision at all of the variouspositions around the seal anchor member's perimeter, thereby reducingthe likelihood of leakage, particularly at the furthermost ends of theelongated incision where conventional seal anchor member have typicallyexperienced the greatest likelihood of leakage.

Referring again to FIG. 1, one or more positioning members 114 may beassociated with either or both of proximal end 102 and distal end 104 ofseal anchor member 100. Positioning members 114 may be composed of anysuitable biocompatible material that is at least semi-resilient suchthat positioning members 114 may be resiliency deformed and may exhibitany suitable elongated configuration, e.g., substantially oblong oroval. Prior to the insertion of seal anchor member 100, positioningmembers 114 are deformed in conjunction with the respective proximal anddistal ends 102, 104 of seal anchor member 100 to facilitate theadvancement thereof through tissue tract 12 (FIG. 6). Subsequent to theinsertion of seal anchor member 100 within tissue tract 12, theresilient nature of positioning members 114 allows positioning membersto return towards their normal, e.g., substantially oblong or oval,configuration, thereby aiding in the expansion of either or both of therespective proximal and distal ends 102, 104 and facilitating thetransition of seal anchor member 100 from its compressed condition toits expanded condition. Positioning members 114 also may engage thewalls defining the body cavity to further facilitate securement of sealanchor member 100 within the body tissue. For example, positioningmember 114 at leading end 104 may engage the internal peritoneal walland positioning member 114 adjacent trailing end 102 may engage theouter epidermal tissue adjacent the incision 12 within tissue “T”. Inanother embodiment of seal anchor member 100, one or more additionalpositioning members 114 may be associated with intermediate portion 106.

The use of seal anchor member 100 will be discussed during the course ofa typical minimally invasive procedure. Initially, the peritoneal cavity(not shown) is insufflated with a suitable biocompatible gas, such asCO₂ gas, such that the cavity wall is raised and lifted away from theinternal organs and tissue housed therein, providing greater accessthereto. The insufflation may be performed with an insufflation needleor similar device, as is conventional in the art. Either prior orsubsequent to insufflation, a tissue tract 12 is created in tissue “T”,the dimensions of which may be varied dependent upon the nature of theprocedure.

Prior to the insertion of seal anchor member 100 within tissue tract 12,seal anchor member 100 is in its expanded condition in which thedimensions thereof prohibit the insertion of seal anchor member 100 intotissue tract 12. To facilitate insertion, the clinician transitions sealanchor member 100 into the compressed condition by applying a force “F”thereto, e.g., by squeezing seal anchor member 100. Force “F” acts toreduce the dimensions D₁ and D₂ of the proximal and distal ends 102,104, respectively, to D₁′ and D₂′ (FIG. 5) including positioning members114 (if provided) and to reduce the dimension “R” of intermediateportion 106 to “R′” such that seal anchor member 100 may be insertedinto tissue tract 12. As best depicted in FIG. 6, subsequent to itsinsertion, distal end 104, positioning member 114 (if provided), and atleast a section 112 of intermediate portion 106 are disposed beneath thetissue “T”. Seal anchor member 100 is caused to transition from thecompressed condition to the expanded condition by removing force “F”therefrom.

During the transition from the compressed condition to the expandedcondition, the dimensions of seal anchor member 100, i.e., therespective dimensions D₁′, D2′ (FIG. 5) of the proximal and distal ends102, 104 are increased towards D₁ and D₂ (FIG. 6) and the dimension “R′”is increased towards “R”. The expansion of distal end 104 is relativelyuninhibited given the disposition thereof beneath tissue “T”, andaccordingly, distal end 104 is permitted to expand substantially, if notcompletely. However, as seen in FIG. 5, the expansion of the section 112of the intermediate portion 106 is limited by the tissue surfaces 14(FIG. 1) defining tissue tract 12, thereby subjecting intermediateportion 106 to an external force “F” that is directed inwardly. Asdiscussed above, this creates an internal biasing force “F_(B1)” that isdirected outwardly and exerted upon tissue surfaces 14, thereby creatinga substantially fluid-tight seal between the seal anchor member 100 andtissue surfaces 14 and substantially inhibiting the escape ofinsufflation gas around seal anchor member 100 and through tissue tract12.

In the expanded condition, the respective dimensions D₁, D₂ of theproximal and distal ends 102, 104 are larger than the dimension “R” ofthe intermediate portion 106. Subsequent to insertion, the dimension D₂of distal end 104 and positioning member 114 is also substantiallylarger than the dimensions of the tissue tract 12. Consequently, sealanchor member 100 may not be removed from tissue tract 12 in theexpanded condition and thus, seal anchor member 100 will remain anchoredwithin the tissue “T” until it is returned to its compressed condition.

After successfully anchoring seal anchor member 100 within the patient'stissue “T”, one or more surgical objects “I” may be inserted throughports 108. FIG. 6 illustrates a surgical object “I” introduced throughone of ports 108. As previously discussed, prior to the insertion ofsurgical object “I”, port 108 is in its first state in which port 108defines an initial dimension D_(P1) which may be negligible in that port108, in one embodiment, is a slit. Accordingly, prior to the escape ofinsufflation gas through port 108, in the absence of surgical object “I”is minimal, thereby preserving the integrity of the insufflatedworkspace.

Surgical object “I” may be any suitable surgical instrument and,accordingly, may vary in size. Suitable surgical objects to beintroduced within one or more of the ports 108 include minimallyinvasive grasper instruments, forceps, clip-appliers, staplers, cannulaassemblies, etc. Upon the introduction of surgical object “I”, port 108is enlarged, thereby transitioning into its second state in which port108 defines a second dimension D_(P2) (FIG. 4) that substantiallyapproximates the diameter D₁ of surgical object “I”, thereby creating asubstantially fluid-tight seal with surgical object “I” andsubstantially inhibiting the escape of insufflation gas (not shown)through port 108 of seal anchor member 100 in the presence of a surgicalobject “I”, as previously discussed.

Turning now to FIGS. 8A-8D, a surgical apparatus, in accordance with analternate embodiment of the present disclosure, is generally designatedas 20. Surgical apparatus 20 is substantially identical to surgicalapparatus 10 and thus will only be discussed in detail herein to theextent necessary to identify differences in construction and operationthereof.

As seen in FIG. 8A, surgical apparatus 20 comprises a seal anchor member200 defining a plurality of ports 208. If seal anchor member 200 definesmore ports 208 than are required for a particular surgical procedure,seal anchor member 200 may be cut to have a fewer number of ports 208.FIGS. 8B-8D illustrate resulting seal anchor members 210, 220, and 230when seal anchor member 200 is cut along segment lines 8B-8B, 8C-8C, and8D-8D respectively. Seal anchor member 200 may include indicia, e.g.,lines or markings along segment lines 8B-8B, 8C-8C, and 8D-8D, etc.,that indicate to a user a location at which to make such a cut ifdesired. Additional or alternatively, the seal anchor member 200 mayinclude a weakened region, e.g., perforations, slits, etc., at suchlocations that facilitate or ease the making of such a cut. Seal anchormember 200 and resulting seal anchor members 210, 220, and 230, may beused in a surgical procedure in a substantially similar manner to sealanchor member 100 as discussed hereinbefore.

As set forth above, the prevent invention, according to variousembodiments thereof, may provide particular advantages for, e.g.,thoracic procedures (for example, thymectomies, lobectomies,pneumonectomy, esophagectomy, mediastinal tumor resection,sympathectomy, etc.) and/or single incision laparoscopic procedures inwhich it may be desirable to access an abdominal cavity off-midline. Forexample, during thoracic procedures, access is typically attained byplacing cannulas or instruments between a patient's ribs. The elongatedshape, when viewed in cross-section, of the seal anchor member, alongwith the linear arrangement of the ports therethrough, allows the sealanchor member to be inserted between a patient's ribs and to move withthe natural curvature of the ribcage. In single incision laparoscopicprocedures, the shape of the seal anchor member may enable it to bepositioned between muscle groups, e.g., parallel to and on the lateraledge of the rectus abdominus muscles. Advantageous positioning of theseal anchor member, as described hereinabove, may provide additionalbenefits of reducing stretching, trauma and post-operative pain.

In some instances, thoracic procedures may not require insufflation. Forother types of surgical procedures, e.g., laparoscopic procedures,insufflation may be used—for these types of procedures, the seal anchormember may be provided with insufflation tubing (not shown) or one ofthe ports may be specifically employed for insufflation purposes.

Although the illustrative embodiments of the present disclosure havebeen described herein with reference to the accompanying drawings, theabove description, disclosure, and figures should not be construed aslimiting, but merely as exemplifications of particular embodiments. Itis to be understood, therefore, that the disclosure is not limited tothose precise embodiments, and that various other changes andmodifications may be effected therein by one skilled in the art withoutdeparting from the scope or spirit of the disclosure.

What is claimed is:
 1. A surgical apparatus for positioning within atissue tract accessing an underlying body cavity, comprising: a sealanchor member comprising a compressible material; the seal anchor memberbeing adapted to transition between a first condition for insertion ofat least a portion of the seal anchor member within the tissue tract anda second condition to facilitate securing of the seal anchor memberwithin the tissue tract and in substantially sealed relation with tissuesurfaces defining the tissue tract, the seal anchor member havingproximal and distal ends and defining a longitudinal axis, the sealanchor member including a plurality of ports extending along an entirelength thereof, at least one of the plurality of ports being adapted forthe reception of an object whereby the compressible material definingthe at least one port is adapted to deform to establish a substantialsealed relation with the object, and wherein the entire seal anchormember has a non-circular cross-section substantially orthogonal to thelongitudinal axis.
 2. The surgical apparatus according to claim 1,wherein the seal anchor member is formed of a foam material.
 3. Thesurgical apparatus according to claim 2, wherein the foam material is atleast partially constituted of a material selected from the groupconsisting of polyisoprene, urethane, and silicone.
 4. The surgicalapparatus according to claim 1, wherein the seal anchor member is formedof a gel material.
 5. The surgical apparatus according to claim 1,wherein the at least one port includes at least one undercut to reducethe likelihood of leaks therethrough.
 6. The surgical apparatusaccording to claim 1, wherein the surgical apparatus includes indiciathat indicates to a user a location at which the apparatus may be cut.7. The surgical apparatus according to claim 1, wherein the plurality ofports is configured linearly with respect to each other.
 8. The surgicalapparatus according to claim 1, wherein each port of the plurality ofports is spaced equally from its neighboring ports.
 9. The surgicalapparatus according to claim 1, wherein the non-circular cross-sectionhas an elongated shape.
 10. The surgical apparatus according to claim 1,wherein the entire seal anchor member has the non-circular cross-sectionwhen the seal anchor member is in an undeformed state.
 11. The surgicalapparatus according to claim 1, wherein the at least one port isintegrally formed with the seal anchor member.
 12. A seal anchor memberformed from a foam material and defining a longitudinal axis, the entireseal anchor member being elongated when viewed in cross-sectionsubstantially across the longitudinal axis, the seal anchor member beingconfigured and dimensioned to be compressed for insertion into anincision and, once inserted, to expand so as to be secured within andseal against the incision, the seal anchor member defining a pluralityof ports extending generally longitudinally along an entire lengththereof, and being adapted for sealed reception of a surgical object.13. The seal anchor member according to claim 12, wherein, when the sealanchor member is positioned within the incision, the seal anchor memberexerts a biasing force against the incision.
 14. The seal anchor memberaccording to claim 13, wherein, when the seal anchor member ispositioned within an elongated incision, the biasing force exerted bythe seal anchor member against the elongated incision is substantiallyequal around a perimeter of the seal anchor member.
 15. The seal anchormember according to claim 12, wherein the foam material is at leastpartially constituted of a material selected from the group consistingof polyisoprene, urethane, and silicone.
 16. A seal anchor member formedfrom a foam material and defining a longitudinal axis, the seal anchormember being configured and dimensioned to be compressed for insertioninto an elongated incision and, once inserted, to expand so as to exerta biasing force against the elongated incision, the entire seal anchormember having an elongated cross-section generally perpendicular to thelongitudinal axis such that the biasing force exerted by the seal anchormember against the elongated incision is substantially equal around aperimeter of the seal anchor member, the seal anchor member including aplurality of ports extending along an entire length thereof, each one ofthe plurality of ports configured for sealed reception of a surgicalobject therethrough.
 17. The seal anchor member according to claim 16,wherein the foam material is at least partially constituted of amaterial selected from the group consisting of polyisoprene, urethane,and silicone.
 18. The seal anchor member according to claim 16, whereinthe seal anchor member defines a major diameter in a first direction anda minor diameter in a second direction that is perpendicular to thefirst direction, the major diameter being greater than the minordiameter.
 19. The seal anchor member according to claim 18, wherein theseal anchor member includes an intermediate portion and an end portion,at least one of a major diameter and a minor diameter of the end portionbeing greater than a major diameter or a minor diameter of theintermediate portion so as to aid in retaining the seal anchor memberwithin the elongated incision.